Importância dos Dispositivos Eletrónicos Cardíacos Implantáveis no Diagnóstico da Síndrome da Apneia do Sono

Introduction: Sleep Apnea Syndrome (SAS) is a prevalent respiratory disease with marked expression in the population with cardiovascular disease. The diagnosis is based on polysomnography. In patients with cardiac implantable electronic devices (CIED), the prevalence of SAS may reach 60%. The objective of this study was to evaluate the value of DEC in the SAS screening. Methods: Prospective study that included patients with CIED with sleep apnea algorithm. The frequency response function was activated and simplified polygraphy was performed. The data of the device were collected on the day of the polygraph. Results: The sample included 29 patients, with a mean age of 76.1 years, 71.4% of the male gender. The prevalence of SAS was 77%. For SAS, the agreement between polysomnography and the Pacemaker was Kappa = 0.54 (p = 0.001), 95% CI (0.28, 0.81) (moderate agreement); for moderate to severe SAS, the agreement was Kappa = 0.73 (p <0.001), 95% CI (0.49, 0.976) (substantial agreement). Severe SAS was obtained: sensitivity 60%, specificity 100%, positive predictive value 100%, negative predictive value 60% and diagnostic accuracy 75%; for moderate to severe SAS: sensitivity of 90%, specificity of 83%, positive predictive values of 90% and negative of 87.5%, with a diagnostic accuracy of 87.5%. Conclusion: SAS is highly prevalent in patients with CIED. The values obtained through these devices have a strong positive correlation with the Apnea-Hypopnea Índex, which makes them a good tool for the screening of severe SAS.info:eu-repo/semantics/publishedVersio

Desenvolvimento de processos de pré-tratamento da biomassa para a separação eficiente das correntes de lenhina e de açúcares

CIES2020 - XVII Congresso Ibérico e XIII Congresso Ibero-americano de Energia SolarRESUMO: O fracionamento da biomassa é um dos principais pontos críticos no desenvolvimento das biorrefinarias. Neste trabalho, são apresentadas três estratégias inovadoras com vista à separação seletiva das frações de celulose, hemicelulose e lenhina, utilizando compostos orgânicos, geralmente em solução aquosa: i) utilização de líquidos iónicos (ILs) em particular [emim][OAc] e [emim][HSO4]); ii) processos organosolv baseados na utilização de misturas etanol:água (50:50); e iii) um processo não aquoso baseado em imidazole. Os processos com ILs permitiram um fracionamento diferencial e, em geral, uma redução da cristalinidade da celulose. Os processos organosolv permitiram modular a distribuição de produtos derivados da hemicelulose e da lenhina entre as fases sólida e líquida. A utilização de imidazole, permitiu a separação das duas frações de polissacáridos e contribuiu para despolimerização da lenhina.ABSTRACT: The biomass fractionation is one of the main critical points in the technological development of biorefineries. In this work, three innovative fractionation strategies aiming the selective separation of the cellulose, hemicellulose and lignin fractions, using organic compounds, generally in aqueous solution, are presented and discussed: i) use of ionic liquids (ILs), in particular [emim][OAc ] and [emim][HSO4]); ii) organosolv process based on ethanol:water mixture (50:50); and iii) a non-aqueous process based on imidazole. The processes with ILs allowed a differential fractionation and, in general a decrease of cellulose crystallinity. The organosolv process enabled the modulation of the distribution of hemicellulose and lignin-derived products between the solid phase and the liquid phase. The use of imidazole, allowed the separation of the two polysaccharide fractions and contributed to lignin depolymerization, producing phenolic compounds whose molecular weight is a function of severity.info:eu-repo/semantics/publishedVersio

Cortical Mechanics and Meiosis II Completion in Mammalian Oocytes Are Mediated by Myosin-II and Ezrin-Radixin-Moesin (ERM) Proteins

Analysis of mouse oocyte mechanics shows that effective tension drops 6-fold from prophase I to metaphase II; the metaphase II egg has a 2.5-fold tension differential between the cortex over the spindle and the opposite cortex. Manipulation of actin, myosin-II, or ERMs alters tension levels and induces spindle abnormalities during meiosis II

Sfrp Controls Apicobasal Polarity and Oriented Cell Division in Developing Gut Epithelium

Epithelial tubular morphogenesis leading to alteration of organ shape has important physiological consequences. However, little is known regarding the mechanisms that govern epithelial tube morphogenesis. Here, we show that inactivation of Sfrp1 and Sfrp2 leads to reduction in fore-stomach length in mouse embryos, which is enhanced in the presence of the Sfrp5 mutation. In the mono-cell layer of fore-stomach epithelium, cell division is normally oriented along the cephalocaudal axis; in contrast, orientation diverges in the Sfrps-deficient fore-stomach. Cell growth and apoptosis are not affected in the Sfrps-deficient fore-stomach epithelium. Similarly, cell division orientation in fore-stomach epithelium diverges as a result of inactivation of either Stbm/Vangl2, an Fz/PCP component, or Wnt5a. These observations indicate that the oriented cell division, which is controlled by the Fz/PCP pathway, is one of essential components in fore-stomach morphogenesis. Additionally, the small intestine epithelium of Sfrps compound mutants fails to maintain proper apicobasal polarity; the defect was also observed in Wnt5a-inactivated small intestine. In relation to these findings, Sfrp1 physically interacts with Wnt5a and inhibits Wnt5a signaling. We propose that Sfrp regulation of Wnt5a signaling controls oriented cell division and apicobasal polarity in the epithelium of developing gut

Silver nanoparticles promote the emergence of heterogeneic human neutrophil sub-populations

Neutrophil surveillance is central to nanoparticle clearance. Silver nanoparticles (AgNP) have numerous uses, however conflicting evidence exists as to their impact on neutrophils and whether they trigger damaging inflammation. Neutrophil’s importance in innate defence and regulating immune networks mean it’s essential we understand AgNP’s impact on neutrophil function. Human neutrophil viability following AgNP or Ag Bulk treatment was analysed by flow cytometry and AnV/PI staining. Whilst AgNP exposure did not increase the total number of apoptotic neutrophils, the number of late apoptotic neutrophils was increased, suggesting AgNP increase transit through apoptosis. Mature (CD16bright/CD62Lbright), immature (CD16dim/CD62Lbright) and apoptotic (CD16dim/CD62Ldim) neutrophil populations were evident within isolated neutrophil preparations. AgNP exposure significantly reduced CD62L staining of CD16bright/CD62Lbright neutrophils, and increased CD16 staining of CD16dim/CD62Lbright populations, suggesting AgNPs trigger neutrophil activation and maturation, respectively. AgNP exposure dramatically increased IL-8, yet not classical pro-inflammatory cytokine release, suggesting AgNP triggers neutrophil activation, without pro-inflammation or damaging, necrotic cell death. For the first time, we show AgNPs differentially affect distinct sub-populations of circulating human neutrophils; activating mature neutrophils with the emergence of CD16bright/CD62Ldim neutrophils. This may stimulate particle clearance without harmful inflammation, challenging previous assumptions that silver nanomaterials induce neutrophil toxicity and damaging inflammatory responses

Monitoração Remota versus Seguimento Hospitalar Presencial em Portadores de Cardioversor-Desfibrilhador: Resultados dum Estudo Randomizado em Portugal

Introduction: Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up. Objective: We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices. Methods: Randomized, pragmatic, open-label controlled trial, with adult wearers of implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy with ICD (CRT-D), eligible for the CareLink® system. Patients newly implanted or with previous conventional follow-up were randomized to RM or conventional follow-up (control), and followed for 12 months, according to the centers' practice. The number of in-office visits and adverse events were compared between groups. Patient and healthcare professionals' satisfaction with RM were described. Results: Of the 134 randomized patients (69 RM; 65 control, aged 60±13 years), 80% were male, 23% employed, 72% ICD wearers and 54% newly implanted. Most patients (70%) reported travel costs less than 15€/visit, and 46% daily routine interference with in-office visits. Median physician/technician time with patient was 15 min/15 min, per in-office visit. Excluding baseline and final visits, control patients had more in-office visits in total: median 1 vs. 0, p<0.001. In 81% of the in-office visits, no clinical measures were taken. There were 10 adverse events, with no differences between groups. At the final visit, 95% of RM patients considered RM easy/very easy to use, and would all prefer to maintain RM and recommend it to others. All professionals found the CareLink website easy/very easy to use and were satisfied with transmission data. Conclusions: In a Portuguese population with ICD and CRT-D, RM safely reduced the burden of in-office visits, with high levels of satisfaction among patients and healthcare professionals.info:eu-repo/semantics/publishedVersio

Monitoração remota versus seguimento hospitalar presencial em portadores de cardioversor-desfibrilhador: resultados dum estudo randomizado em Portugal

© 2022 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)Introduction: Remote monitoring (RM) is a safe and effective alternative to in-office conventional follow-up. Objective: We aimed to evaluate patient satisfaction with RM and its impact on healthcare resources in a population with cardiac implantable electronic devices. Methods: Randomized, pragmatic, open-label controlled trial, with adult wearers of implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy with ICD (CRT-D), eligible for the CareLink® system. Patients newly implanted or with previous conventional follow-up were randomized to RM or conventional follow-up (control), and followed for 12 months, according to the centers' practice. The number of in-office visits and adverse events were compared between groups. Patient and healthcare professionals' satisfaction with RM were described. Results: Of the 134 randomized patients (69 RM; 65 control, aged 60±13 years), 80% were male, 23% employed, 72% ICD wearers and 54% newly implanted. Most patients (70%) reported travel costs less than 15€/visit, and 46% daily routine interference with in-office visits. Median physician/technician time with patient was 15 min/15 min, per in-office visit. Excluding baseline and final visits, control patients had more in-office visits in total: median 1 vs. 0, p<0.001. In 81% of the in-office visits, no clinical measures were taken. There were 10 adverse events, with no differences between groups. At the final visit, 95% of RM patients considered RM easy/very easy to use, and would all prefer to maintain RM and recommend it to others. All professionals found the CareLink website easy/very easy to use and were satisfied with transmission data. Conclusions: In a Portuguese population with ICD and CRT-D, RM safely reduced the burden of in-office visits, with high levels of satisfaction among patients and healthcare professionals.Introdução A monitoração remota (MR) é uma alternativa segura e eficaz ao acompanhamento convencional em consulta hospitalar. Objetivo Avaliar a satisfação dos doentes e o impacto nos recursos de saúde dum programa de MR numa população de portadores de dispositivos eletrónicos cardíacos implantáveis. Métodos Ensaio clínico randomizado, aberto, controlado, com adultos portadores de cardioversor-desfibrilhador implantável (CDI) ou sistema de ressincronização cardíaca com CDI (CRT-D) elegíveis para MR com sistema CareLink®. Os doentes com implantação recente ou com acompanhamento convencional prévio foram randomizados para MR ou seguimento convencional (controle) e acompanhados por 12 meses, de acordo com a prática dos centros. O número de visitas hospitalares em consulta e os eventos adversos foram comparados entre os grupos. Foi analisada a satisfação dos doentes e profissionais de saúde relativamente à utilização da MR. Resultados Dos 134 doentes randomizados (69 MR; 65 controle, idade 60 ± 13 anos), 80% eram do sexo masculino, 23% estavam empregados e ativos, 72% eram portadores de CDI e 54% tinham implantação recente. A maioria dos doentes (70%) reportou custos de viagem <15€/visita hospitalar e 46% referiram interferência na rotina diária devido às consultas hospitalares presenciais. O tempo mediano do doente com o médico/cardiopneumologista foi de 15 min/15 min por consulta hospitalar. Excluindo as consultas inicial e final, o grupo controle teve mais visitas hospitalares no total: mediana 1 versus 0, p<0,001. Em 81% das consultas presenciais não foi tomada medida clínica adicional. Houve 10 eventos adversos, sem diferenças entre os grupos. Na avaliação final, 95% dos doentes com MR consideraram a sua utilização fácil ou muito fácil e todos prefeririam manter a MR e recomendá-la a outros. Todos os profissionais de saúde acharam a plataforma CareLink fácil ou muito fácil de usar e revelaram satisfação com os dados das transmissões. Conclusão Numa população portuguesa com CDI e CRT-D, a MR reduziu de forma segura a carga de consultas hospitalares presenciais, com elevados níveis de satisfação dos doentes e profissionais de saúde.info:eu-repo/semantics/publishedVersio